Evaluating the Adequacy of Giro-Couch to Support Prone Breast Boost Irradiation Using IMRT Technique With IGRT.

Exclusion Criteria

• •T0, T2 (\> 3.0 cm), T3, stage III, or stage IV breast cancer (see Appendix A for TNM nomenclature and staging).
• •Suspicious microcalcifications, densities, or palpable abnormalities (in the ipsilateral or contralateral breast) unless biopsied and found to be benign.
• •Non-epithelial breast malignancies such as sarcoma or lymphoma.
• •Proven multicentric carcinoma (invasive cancer or DCIS) in more than one quadrant or separated by 4 or more centimeters.
• •Paget's disease of the nipple.
• •Synchronous bilateral invasive or non-invasive breast cancer.
• •Surgical margins that cannot be microscopically assessed or are positive at pathologic evaluation. (If surgical margins are rendered free of disease by re-excision, the patient is eligible.)
• •Clear delineation of the extent of the target lumpectomy cavity not possible.
• •Breast implants.
• •Prior breast or thoracic RT for any condition
• •Collagen vascular disease, specifically dermatomyositis, systemic lupus erythematosis, or scleroderma.
• •Pregnancy or lactation at the time of proposed randomization. Women of reproductive potential must agree to use an effective non-hormonal method of contraception during therapy.
• •Psychiatric or addictive disorders or other conditions that, in the opinion of the investigator, would preclude the patient from meeting the study requirements.